Objective To investigate the significance and prognostic value of integrin α5,β1 andβ2 in colorectal cancer(CRC).Methods The clinical data of 187 patients with CRC who were diagnosed in the hospital from January 2017 to January 2018 were analyzed retrospectively.The expression of integrin α5,β1and β2 in cancer tissues and adjacent tissues,and its relationship with pathological characteristics of CRC were analyzed.All patients were followed up for 5 years after operation.Postoperative recurrence and survival time were recorded.Results The positive expression rates of integrin α5,β1 and β2 in cancer tissues were higher than adjacent tissues(P＜0.05).There was no statistically significant difference in the expression levels of integrin α5,β1 and β2 in patients of different gender,patients of different age and patients with different tumor diameters(P＞0.05).The expression levels of integrin α5,β1 and β2 in patients with different differentiation degrees,patients in different TNM stages,and patients with and without lymph node metastasis were significantly different(P＜0.05).All of the 187 patients were followed up for 5 years,without any case lost to follow-up,and a total of 84 patients had recurrence.The positive expression rates of integrin α5,β1 and β2 in patients with recurrence were higher than those in patients without(P＜0.05).The average survival time and survival rate of patients with positive expression of integrin α5,β1and β2 were shorter/lower than those of patients with negative expression(P＜0.05).Conclusion The positive expression rates of integrin α5,β1and β2 in CRC patients are increased.They are closely related to differentiation degree,TNM stage and lymph node metastasis,and influence postoperative recurrence and survival time of the patients.Therefore,the above indicators can be used for prognosis.

Objective:To investigate the feasibility and therapeutic effects of a self-designed portable enteral nutrition (EN) kit for home EN in patients with acute pancreatitis (AP) .Methods:A total of 60 patients suffered from moderately severe AP and severe AP and needed home EN in Department of Gastroenterology of First Affiliated Hospital of Naval Medical University between April 2022 and June 2023 were enrolled. They were randomly assigned to portable EN group (observation group, n=28) and routine EN group (control group, n=29) according to random number table. All patients were given EN guidance before discharge. After discharge, all patients were given weekly telephone follow-up to guide the resolution of home EN problems. Patients were followed up from discharge to extubation. The age, gender, body mass index (BMI), disease severity, laboratory indicators (white blood cell, hemoglobin, albumin, total protein), AP related complications before discharge were recorded. During the follow-up period, changes in BMI, laboratory indicators, gastrointestinal symptoms, infection related complications, nutrition tube related complications and Barthel index were recorded. Results:all indicators in the two groups were not significantly statistically different, which comparable at baseline. During the 1-week, 2-week, 3-week and 4-week follow-up period, there was no significant difference on the incidence of infection and complications related to nutrition tube between the two groups, while the incidence of gastrointestinal symptoms in observation group was significantly lower than that in control group and the difference was statistically significant ( P<0.05). At the 3-week and 4-week follow-up, the BMI [ (22.38±3.84) vs (20.38±3.56) kg/m 2; (22.59±3.77) vs (20.54±3.37) kg/m 2], hemoglobin [ (125.00±13.46) vs (113.4±13.64) g/L; (126.20±14.37) vs (114.3±13.25) g/L], and albumin [ (40.96±3.07) vs (39.17±3.31) g/L; (41.79±2.73) vs (39.97±2.67) g/L] levels of the observation group were significantly higher than those of the control group; the living ability score of the observation group was significantly higher than that of the control group (87.32±5.85 vs 82.59±9.79; 89.64±1.31 vs 83.97±8.80) ; and all the differences were statistically significant (all P value <0.05) . Conclusions:The application of portable EN kit can help reduce the gastrointestinal symptoms of AP patients who need long-term home EN, improve nutritional status and life ability.

Objective:To investigate the level of functional fitness of elderly hypertensive patients in the community and to analyze its influencing factors.Methods:A cross-sectional survey was used from November 2021 to September 2022, questionnaire survey and Senior Functional Fitness Test (SFT) were conducted on 189 elderly hypertensive patients in the community by convenience sampling method, multiple linear regression was used to analyze the influencing factors of SFT in elderly hypertensive patients in the community.Results:Totally 189 cases of community-aged hypertensive patients completed the investigation, 88 cases were male and 101 were female. The total SFT score of community-aged hypertensive patients was (58.61 ± 16.07). Single factor analysis showed that there were significant differences in SFT scores among patients with different gender, age and education ( t=-2.57, F=6.24, 7.54, all P<0.05). Multifactorial analysis revealed that age ( t=-5.55), gender ( t=2.63), and literacy ( t=5.69) were influential factors in the total SFT scores of community-dwelling elderly hypertensive patients (all P<0.05). Conclusions:Age, gender, and literacy level are the main factors affecting the total SFT scores of elderly hypertensive patients in the community, and community caregivers should pay close attention to the above elderly hypertensive population.

Objective To explore the influencing factors hindering compliance of discharged patients with coronary heart disease on enhanced external counterpulsation(EECP),and to provide basis for formulating corresponding intervention strategies.Methods A semi-structured interview method was used to conduct in-depth interviews on 19 patients with coronary heart disease who received EECP treatment during hospitalization in Gansu Provincial Hospital from March 2020 to August 2021 but withdrew from the EECP treatment program after discharge.According to phenomenological theory,the Colaizzi 7-step analysis method was applied to analyze the interview data.Results Cognitive factors(insufficient understanding of the disease and EECP treatment),objective factors(distance,transportation,economy,time,epidemic impact)and psychological factors were all influencing factors that hinder the compliance of patients discharged from coronary heart disease with EECP treatment.Conclusion In order to improve the enthusiasm and compliance of discharged patients with coronary heart disease to participate in EECP treatment,the medical staff should formulate intervention measures according to the influencing factors of the lack of EECP treatment compliance of discharged patients with coronary heart disease from the cognitive factors,objective factors and psychological factors of patients.

Objective To find out the willingness to choose old-age care mode and the influencing factors of the elderly in the younger age group.Methods A multi-stage stratified whole cluster random sampling method was used to conduct a questionnaire survey on the willingness of the younger elderly in Zhangye City.Results The proportion of low-aged elderly in Zhangye City who chose family old-age care was the highest,and factors such as who they relied on to solve their old-age problems,opinions on moving into old-age care institutions,knowledge of the combination of medical care and nursing care,loneliness,and the number of chronic illnesses affected the willingness of low-aged elderly to live in old-age care.Conclusion In Zhangye City,family care is the main mode of old-age care for low-aged elderly.In the future,the relevant government departments should take into account the diversified needs of the elderly and the characteristics of the influencing factors,in order to realise the precise supply of the demand for elderly care services for the elderly.

Objective:To investigate the accuracy of magnetic resonance imaging (MRI) cine sequences in determining the range of tumor motion in radiotherapy, providing a basis for the precise delineation of the target volume in motion for radiation therapy.Methods:A modified chest motion phantom was placed in a MRI scanner, and a water-filled sphere was used to simulate a tumor. True fast imaging with steady precession (TrueFISP) MRI cine sequences from Siemens were used to capture the two-dimensional motion images of the simulated tumor. The phantom experiments were divided into three modes: head-foot motion mode, rotation motion mode, and actual respiratory waveform mode. In the head-foot motion mode, respiratory motion period (3, 4, 5, 6, 7 and 8 s), amplitude (5, 10 and 15 mm), and respiratory waveform of the simulated tumor (sin and cos4) were set, resulting in a total of 36 motion combinations. In the rotation motion mode, a cos4 waveform was used for respiration, with respiratory periods of 3, 4, 5, 6, 7 and 8 s, head-foot motion set amplitudes of 5, 10 and 15 mm, and anterior-posterior (AP) and left-right (LR) motion set amplitudes in three combinations ([2.5, 2.5] mm, [2.5, 5.0] mm, [5.0, 5.0] mm), resulting in a total of 54 motion combinations. In the actual respiratory waveform mode, respiratory waveforms of 5 randomly selected patients from Affiliated Cancer Hospital of Zhengzhou University were obtained. Under each motion combination, TrueFISP cine images (30 frames, with an acquisition time of 11 s per frame) were obtained. The code was used to automatically identify the two-dimensional coordinates of the center of the simulated tumor in each image, and sin and cos4 functions were separately employed to fit the tumor position in the motion direction, thereby obtaining the fitted motion period and amplitude. The difference between the maximum and minimum values of the tumor's center coordinates in the head-to-foot direction is taken as the range of movement, referred to as the calculated amplitude. For the actual respiratory waveform, the distance between the measured maximum and minimum positions is used to calculate the amplitude.Results:In the head-foot motion mode, the fitted amplitudes of both sin and cos4 waveforms deviated from the set amplitudes by 0-0.51 mm, with relative deviations of 0%-4.2%. The deviation range between the calculated amplitudes and the set amplitudes of the two waveforms were 0.08-0.94 mm, with relative deviations of 1.1%-6.3%. In the rotation motion mode, the fitted amplitudes deviated from the set amplitudes by 0-0.61 mm, with relative deviations of 0%-6.2%. And the deviation range between the calculated amplitudes and the set amplitudes were 0.16-0.94 mm, with relative deviations of 0%-6.3%. In the actual respiratory waveform motion mode, the deviation range between the calculated amplitudes and the set amplitudes were 0.10-0.48 mm, with relative deviations of 2.2%-8.6%.Conclusion:TrueFISP cine sequences show minimal deviations in determining the range of tumor head-foot motion and effectively captures the tumor's movement state, thereby providing important support for the precise definition of the tumor movement target area during radiotherapy .

ObjectiveTo establish a dose-effect curve for semi-automatic analysis of dicentric chromosomes(DC) based on an automatic chromosome analysis system. Methods A total of three healthy volunteers were recruited as the study subjects, and their peripheral blood was collected and stimulated by X-ray at doses of 0.00, 0.10, 0.25, 0.50, 0.75, 1.00, 2.00, 3.00, 4.00, and 5.00 Gy, with the absorbed dose rate of 1.0 Gy/min. Images of DC in the mid-stage of cell division were collected using a high-throughput automatic chromosome analysis system. The DCScore software was used to automatically analyze DC aberrations, and a dose-effect curve for semi-automatic analysis of DC was fitted after manual confirmation. The fitted dose-effect curve for semi-automatic analysis of DC was validated for accuracy using three proficiency test samples from the national quality assessment of biological dose. Results The incidence of DC increased with increasing irradiation doses in the range of 0.00-5.00 Gy (P<0.01). The dose-effect curve for the fitted semi-automatic analysis of DC was ŷ =0.000 8 (±0.000 2) +0.009 2(±0.000 9) D+0.014 2(±0.000 4) D² (R²= 0.999 8). The relative deviation between the estimated dose and the actual dose of the three test samples was about 20.00%, indicating curve applicability for biological dose estimation. Moreover, excluding the time spent on manual analysis, the semi-automatic analysis method increased the analysis efficiency by 26.0 times. Conclusion The semi-automatic analysis dose-effect curve for DC stimulated by X-ray is constructed for biological dose estimation, which can reduce the manual analysis time, and holds great potential for application in nuclear emergency response to large-scale radiation accidents.

Objective To establish a simultaneous detection approach for 34 emerging contaminants(ECs)in tap water by liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).Human health risk assessment was performed according to the detection results from 43 tap water samples.Methods Tap water samples were concentrated and extracted by solid phase extraction,and then blown to near dry by nitrogen at 40℃.The sample extracts were dissolved in methanol-water solution(95:5,VN)to 0.5 mL for analyzing.Agilent Jet Stream Electrospray Ionization(AJS ESI)and the multiple reaction monitoring(MRM)mode were performed for MS to acquire the data of 34 ECs.A database including precursor ion,product ion and retention times was established accordingly.Results The average linear correlation coefficients(r)of 34 kinds of ECs was 0.995 9.The limits of detection were 0.01～0.60 ng/L and the recoveries were between 60.7％and 119.8％.The intra-group precisions were between 0.05％～9.89％and the intra-day precisions were between 0.20％～14.40％for the spiked samples.The method was applied to analyze 43 tap water samples and a total of 15 ECs were detected.According to the results,the detection rate of caffeine was the highest(84％),and the concentration range was ND～74.42 ng/L.Among all the ECs detected,1,2,3-benzotriazole had the highest concentration(ND～361.15 ng/L),where detection rate was 44％.Humans may be exposed to these ECs by drinking the tap water.The human health risk assessments of 12 kinds of ECs were carried out,however,the estimated risk was negligible(risk quotient＜0.01).Conclusion The method is simple,highly sensitive and selective,and could meet the detection needs of ECs at trace level in tap water.There was no human health risk posed for ECs identified in 43 tap water samples analyzed by this method.

Objective:To analyze the current status of anesthesiology research in the world and China in 2023 and to identify the anesthesiology research hotspots using bibliometrics.Methods:The literature related to anesthesiology published in PubMed in 2023 was searched, and the country and author of the literature, as well as the key words of the literature were visually analyzed by using the software CiteSpace6.2. R4.Results:A total of 22 473 articles were included, the country with the largest number of publications was the United States, and China ranked second. The author with the highest number of publications in the field of anesthesiology in the worldwide in 2023 was Kaye Alan D from the United States. Chronic pain, general anesthesia and pain management were the research hotspots in the field of anesthesiology worldwide in 2023. The research hotspots in the field of anesthesiology in China focused on general anesthesia, oxidative stress and neuropathic pain.Conclusions:The United States is the leader in the research in the field of anesthesiology, with China following behind. The keywords of the literature in the field of anesthesiology between China and the world are roughly the same, reflecting the convergence of Chinese scientific research with global scientific research. Domestic anaesthesia practitioners can refer to or learn from the research hotspots of related countries and strengthen communication and cooperation between teams while conducting academic research.

Objective:To observe the multi-modal fundus imaging features of subretinal drusenoid deposit (SDD) in age-related macular degeneration (AMD), and observe image features.Methods:A prospective clinical study. From December 2019 to December 2023, 65 patients (104 eyes) with a diagnosis of AMD-SDD by spectral domain optical coherence tomography (SD-OCT) examination in Shandong Eye Hospital were included. All eyes were examined by best corrected visual acuity (BCVA), traditional color fundus photography (CFP), ultra-wide-angle scanning laser fundus imaging (UWF), multicolor scanning laser fundus imaging (MC) and SD-OCT. The standard MC images were obtained by using Spectralis HRA+OCT for MC examination. The multi-mode image characteristics of SDD were analyzed retrospectively. Area under curve (AUC) was used to evaluate the sensitivity and specificity of CFP, MC and UWF in detecting SDD.Results:Among 65 patients with SDD, 29 cases of males (52 eyes) and 36 cases of females (52 eyes) was included. There were 26 patients with unilateral SDD and 39 patients with bilateral SDD. The average age was (71.74±10.97) years. The early, middle and late stages of AMD were 31 (29.8%, 31/104), 24 (23.1%, 24/104), 49 (47.1%, 49/104) eyes, respectively. The SDD detected by CFP, MC and UWF was 76 (73.1%, 76/104), 94 (90.4%, 94/104), 96 (92.3%, 96/104) eyes. CFP showed that the edge of SDD in the macular area was blurred. UWF showed that the dot and the ribbon SDD were light yellow pale discrete deposits and light yellow interlaced network deposits respectively. MC showed the dot SDD had a strong yellow-green circular reflection, while the edge of the ribbon SDD was surrounded by a weak reflection, and the boundary was clear. SD-OCT showed that SDD had strong reflection signal, which was located between the retinal pigment epithelium layer and the photoreceptor cell layer. The dot SDD could break through the ellipsoid zone and caused slight uplift or interruption of the external membrane, showing a cone-like strong reflection signal. While the ribbon SDD showed a continuous "hill-like" protrusion, which hardly broke through ellipsoid zone. The sensitivity and specificity of CFP, MC and UWF for SDD were 73.1%, 90.4%, 92.3% and 61.1%, 94.4% and 83.3%, respectively.Conclusions:MC and UWF show high sensitivity and specificity in diagnosing AMD-SDD, which is superior to CFP. SD-OCT can effectively reveal the location and morphoLogical characteristics of SDD under retina.